1/122. Antiangiogenic therapy of a recurrent giant cell tumor of the mandible with interferon alfa-2a.We report a 5-year-old girl with a large rapidly growing giant cell tumor of the mandible that recurred 2 months after the first surgical excision and 3 months after a second resection. An angiogenic protein, (bFGF), was abnormally elevated in her urine. The patient was treated with interferon alfa-2a for 1 year because this agent inhibits angiogenesis by suppressing bFGF overexpression in infantile hemangiomas and in other human tumors. During this time the bone tumor regressed and disappeared, the urinary bFGF fell to normal levels, and the mandible regenerated. She has remained tumor-free and has been off therapy for 3 years at this writing. This first successful use of interferon alfa-2a to treat a mandibular tumor in a child demonstrates: 1) low grade tumors that overexpress bFGF may respond to interferon alfa-2a, in a manner similar to life-threatening infantile hemangiomas; 2) antiangiogenic therapy, given without interruption for 1 year, was safe and effective in this patient; and 3) treatment may be continued for 1 year without the development of drug resistance.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/122. Clinical delivery of intensity modulated conformal radiotherapy for relapsed or second-primary head and neck cancer using a multileaf collimator with dynamic control.BACKGROUND AND PURPOSE: Concave dose distributions generated by intensity modulated radiotherapy (IMRT) were applied to re-irradiate three patients with pharyngeal cancer. patients, MATERIALS AND methods: Conventional radiotherapy for oropharyngeal (patients 1 and 3) or nasopharyngeal (patient 2) cancers was followed by relapsing or new tumors in the nasopharynx (patients 1 and 2) and hypopharynx (patient 3). Six non-opposed coplanar intensity modulated beams were generated by combining non-modulated beamparts with intensities (weights) obtained by minimizing a biophysical objective function. Beamparts were delivered by a dynamic MLC (Elekta Oncology Systems, Crawley, UK) forced in step and shoot mode. RESULTS AND CONCLUSIONS: Median PTV-doses (and ranges) for the three patients were 73 (65-78), 67 (59-72) and 63 (48-68) Gy. Maximum point doses to brain stem and spinal cord were, respectively, 67 Gy (60% of volume below 30 Gy) and 32 Gy (97% below 10 Gy) for patient 1; 60 Gy (69% below 30 Gy) and 34 Gy (92% below 10 Gy) for patient 2 and 21 Gy (96% below 10 Gy) at spinal cord for patient 3. Maximum point doses to the mandible were 69 Gy for patient 1 and 64 Gy for patient 2 with, respectively, 66 and 92% of the volume below 20 Gy. A treatment session, using the dynamic MLC, was finished within a 15-min time slot.- - - - - - - - - - ranking = 0.16666666666667keywords = mandible (Clic here for more details about this article) |
3/122. role of radical surgery for intracranial melanotic neuroectodermal tumor of infancy: case report.OBJECTIVE AND IMPORTANCE: Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, locally aggressive tumor that arises most commonly from the maxilla or mandible. Infrequently, it originates from the cranial vault, and recent reports have described a favorable outcome after radical surgery. Some lesions are particularly problematic, such as those located along the cranial midline or cranial base and those with significant intracranial extension. Currently, there is no effective adjuvant therapy for MNTI; radiation is precluded by the patients' young age, and chemotherapy trials have not demonstrated long-term efficacy. CLINICAL PRESENTATION: A 2-month-old infant boy presented with a firm, immobile subcutaneous mass behind the right ear. The mass had been present at birth and enlarged with time. INTERVENTION: Initial resective surgery down to the dura resulted in massive tumor recurrence within weeks. Successful management required repeat surgery including excision of the dura and dural venous sinuses. CONCLUSION: This patient's large MNTI of the cranial base was successfully managed by radical surgery. Although MNTI is a rapidly growing tumor that is locally highly invasive, radical surgery may be associated with a favorable outcome and offers the potential for long-term cure.- - - - - - - - - - ranking = 0.16666666666667keywords = mandible (Clic here for more details about this article) |
4/122. Odontogenic ghost cell carcinoma: report of four new cases and review of the literature.Only 12 odontogenic ghost cell carcinomas (OGCC) have been reported in the English language literature to date. This article reports four additional cases of this rare odontogenic tumour and examines them in relation to those previously described. Judging from the number of published cases, the OGCC is more prevalent in Asians than other racial groups, occurs more often in the maxilla than the mandible, and is slightly more common in males than females. Histologically, elements of a benign calcifying odontogenic cyst (COC) can be identified in all the malignant variants, either separated or admixed with the malignant epithelial component. The latter can consist of either small basaloid cells or large epithelial cells. Despite the differing histological presentations, the biological behavior of the tumour is unpredictable, with some cases characterized by relatively indolent growth and others by a locally aggressive and potentially fatal course. The tumour apparently arises most often from malignant transformation of a preexisting benign COC, although it may also develop from other odontogenic tumours.- - - - - - - - - - ranking = 0.16666666666667keywords = mandible (Clic here for more details about this article) |
5/122. Cytology of recurrent ameloblastoma with malignant change. A case report.BACKGROUND: ameloblastoma is a rare tumor of the jaw that arises from the odontogenic epithelium. Ameloblastomas have a propensity for local recurrence and, rarely, for metastasis. The term malignant ameloblastoma is reserved for those metastasizing tumors that retain the typical morphology of ameloblastoma. Fine needle aspiration (FNA) reports on ameloblastomas are scant, and those on malignant ameloblastomas are still more so. CASE: In a case of malignant ameloblastoma diagnosed by FNA cytology, the clinical presentation was that of a malignant neoplasm. FNA smears were highly cellular and showed isolated, scattered cells and small groups of basaloid cells and polygonal squamous epithelial cells. Stellate and spindle-shaped cells were also seen in the background. The cytologic diagnosis was subsequently confirmed on histopathology. CONCLUSION: The characteristic combination of cells in FNA smears facilitated the diagnosis of ameloblastoma. Since the biologic behavior of the tumor was that of a malignant neoplasm, the slides were reviewed. The cytologic smears did not exhibit sufficient features of malignancy to label the lesion malignant.- - - - - - - - - - ranking = 0.0052411582123195keywords = jaw (Clic here for more details about this article) |
6/122. Metastatic neuroblastoma of the mandible mimicking osteogenic sarcoma radiologically. Case report.This paper presents a case of a neuroblastoma of the adrenal gland metastasizing to the mandible of a 21-month-old infant, which presented radiographically as the so-called 'sun-ray' appearance, characteristic of osteogenic sarcoma.- - - - - - - - - - ranking = 0.83333333333333keywords = mandible (Clic here for more details about this article) |
7/122. So-called 'hybrid' lesion of desmoplastic and conventional ameloblastoma: report of a case and review of the literature.So-called 'hybrid' lesion of ameloblastoma, which is composed of desmoplastic ameloblastoma and conventional follicular/plexiform ameloblastoma, is an unusual variant of ameloblastoma and only eight cases of 'hybrid' lesion have been published in the English literature. To enhance knowledge of this interesting tumor, we add a case of 'hybrid' lesion that occurred in the right mandible of a 48-year-old Japanese male. Radiographic examination disclosed a honeycomb appearance at the anterior alveolar region, combined with a unicystic radiolucency in the molar region of the mandibular body. Histologically, the former showed microscopic features of desmoplastic ameloblastoma and the latter those of follicular ameloblastoma with focal granular cell transformation. The lesion was enucleated with curettage of surrounding bone and the lesional cavity was marsupialized. Although tumor tissues reappeared at 3, 5, 7 and 14 months after the surgery, the patient has remained disease free for 11 years after the last vaporization by CO2 laser of the recurred tumor. Many more cases of 'hybrid' lesion are needed to clarify the clinicopathological, histopathological and biological characteristics of this interesting variant of ameloblastoma.- - - - - - - - - - ranking = 0.16666666666667keywords = mandible (Clic here for more details about this article) |
8/122. Osteosynthesis and bony healing between two consecutive free fibular bone grafts.This case report describes a recurrent squamous cell carcinoma in the oral cavity requiring two consecutive free fibula transfers at different times. In a unique application of the fibula, rigid miniplate fixation was used between the two independent free flaps to reconstitute the contour of the mandible for an extensive composite oromandibular defect, extending from the left angle to the right ascending ramus. This application underscores the utility of the free osteocutaneous fibular flap for reconstruction of complex mandibular defects.- - - - - - - - - - ranking = 0.16666666666667keywords = mandible (Clic here for more details about this article) |
9/122. Intraosseous squamous cell carcinoma arising in association with a squamous odontogenic tumour of the mandible.We report a rare occurrence of intraosseous squamous cell carcinoma (SCC) arising in association with a squamous odontogenic tumour (SOT), which had not previously been documented in the literature. A 53-year-old man had, for 5 years, a well-demarcated radiolucency attached to the impacted third molar of the mandible. The enucleated specimen had a characteristic pattern of SOT, but in which a few epithelial islands showed atypical features suggestive of SCC. Intense p53-, proliferating cell nuclear antigen- and Ki-67-positive cells were detected in carcinoma areas. Within 2 months, aggressive bone destruction showing typical findings of intraosseous SCC appeared. The present tumour is presumably a malignant variant of SOT.- - - - - - - - - - ranking = 0.83333333333333keywords = mandible (Clic here for more details about this article) |
10/122. Melanotic neuroectodermal tumor of infancy in the mandible: report of a case.A case of melanotic neuroectodermal tumor of infancy occurring in the mandible is described. The patient was a 1-month-old boy with a rapidly growing tumor of the mandible. Computed tomography showed 2 well-defined osteolytic lesions in the right mandible. Histopathologic diagnosis of a biopsy specimen was melanotic neuroectodermal tumor of infancy. The tumor was excised with removal of the surrounding bone, but 1(1/2) months later it recurred, and segmental mandibulectomy and reconstruction of the defect with a titanium miniplate was performed. Retrospectively, evidence of recurrence was noted on computed tomography taken on the tenth postoperative day. The recurrence was caused by incomplete removal of the tumor. Histopathologically, the tumor cells of the recurrent lesion were dispersed extensively in the bone marrow, and bone remodeling was active. The surgical procedure may have stimulated tumor cell proliferation and reactive bone formation. The patient was followed for 2 years with no evidence of recurrence or metastasis.- - - - - - - - - - ranking = 1.1666666666667keywords = mandible (Clic here for more details about this article) |
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